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Should aortic stiffness parameters be used in MIS-C patient follow-up?
Hatice Uygun1, Celal Varan2, Capan Konca3
1Department of Pediatric Infectious Disease, Gaziantep University School of Medicine, University Boulevard, Sehitkamil-Gaziantep, 27310, Turkey. ozhanhatice@hotmail.com.
Insights
Multisystem inflammatory syndrome in children (MIS-C) can cause cardiovascular issues, but most echocardiographic findings improve within six months. Continued cardiovascular monitoring for at least six months is recommended for MIS-C patients.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Cardiovascular Research
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a serious condition affecting multiple organs, including the heart.
- Understanding the cardiovascular impact of MIS-C is crucial for patient management and long-term outcomes.
Purpose of the Study:
- To evaluate the short- and long-term cardiovascular effects of MIS-C in children.
- To compare echocardiographic and aortic stiffness parameters in MIS-C patients versus controls.
- To determine the recovery trajectory of cardiovascular abnormalities within six months post-diagnosis.
Main Methods:
- Retrospective study comparing 38 MIS-C patients with 55 controls.
- Standard echocardiographic measurements and aortic stiffness parameters were assessed.
- Comparisons were made at diagnosis and at a six-month follow-up.
Main Results:
- At diagnosis, MIS-C patients showed higher rates of mitral valve insufficiency (42%), left ventricular systolic dysfunction (36%), and coronary artery dilatation (31%).
- Ejection fraction and pulse pressure were significantly lower in MIS-C patients compared to controls (p<0.01, p=0.045).
- Aortic stiffness parameters were elevated in MIS-C patients, with significant differences in aortic distensibility (p=0.029), but these normalized by six months.
Conclusions:
- Many cardiovascular abnormalities detected at MIS-C diagnosis resolve within six months.
- Aortic stiffness parameters, though initially elevated, showed a trend towards normalization.
- A minimum six-month cardiovascular follow-up is warranted for children diagnosed with MIS-C.
Abstract:
We evaluated the short- and long-term effects of multisystem inflammatory syndrome in children (MIS-C) on their cardiovascular system. The study population consisted of 38 MIS-C patients and 55 control patients. Standard echocardiographic measurements and aortic stiffness parameters were compared between the two groups at different time points. During the standard echocardiographic examination at the time of diagnosis, mitral valve insufficiency was detected in 42% of the cases, left ventricular systolic dysfunction in 36%, aortic valve insufficiency in 3%, tricuspid valve insufficiency in 13%, and coronary artery dilatation in 31%. The ejection fraction, pulse pressure of the experimental group were significantly lower than the control group (p < 0.01, p = 0.045, respectively). When aortic stiffness parameters were compared, it was seen that the parameters increased in the experimental group and the difference was significant for aortic distensibility. (p = 0.105, p = 0.029 respectively). When comparing the experimental group's results at diagnosis and at the sixth month, there was a decrease in aortic stiffness parameters at the sixth month compared to the time of diagnosis, but the difference wasn't significant (p = 0.514, p = 0.334). However, no statistically significant difference was detected when comparing the aortic distensibility results of the experimental group with the control group at the sixth month (p = 0.667). Our results showed that many pathological echocardiographic findings detected at diagnosis in MIS-C patients returned to normal within six months. Therefore, we believe that the cardiovascular follow-up period of MIS-C cases should be at least six months.
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